Impulsivity In Cocaine Abusers: Relationship to Drug Taking and Treatment Outcome

可卡因滥用者的冲动：与吸毒和治疗结果的关系

• 批准号: 8694439
• 负责人: Richard W Foltin
• 金额: $ 52.77万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8694439
• 关键词: Accounting; Age; Alcohol consumption; Behavioral; Behavioral inhibition; Binge Eating; Brain; Clinical; Cocaine; Cocaine Abuse; Cocaine Users; Cognitive; Cognitive Therapy; Control Groups; Data; Decision Making; Drug usage; Economics; Ethnic Origin; Exercise; Factor Analysis; Female; Foundations; Functional Magnetic Resonance Imaging; Future; Impulsive Behavior; Impulsivity; Laboratories; Measures; Modeling; Outcome; Participant; Patient Self-Report; Personality; Personality Traits; Pharmaceutical Preparations; Play; Process; Public Health; Punishment; Research; Research Design; Rewards; Risk-Taking; Role; Smoke; Structural Models; Structure; Testing; Treatment outcome; base; clinically relevant; cocaine use; discount; discounting; high risk sexual behavior; male; neurobehavioral; neuroimaging; novel; public health relevance; relating to nervous system; response; sex; social; success; therapy development; treatment strategy

DESCRIPTION (provided by applicant): Cocaine users 1) are more impulsive based on self-report measures, 2) have more difficulty inhibiting behavioral responses, 3) make poorer decisions in decision-making tasks, and 4) discount the value of future rewards at a faster rate than non-cocaine users, suggesting that impulsivity plays a role in cocaine abuse. After collecting data on these 4 domains in current cocaine abusers (n = 200) and matched controls (n = 180), we will conduct confirmatory factor analyses testing a second-order factor model of Impulsive Choice. We hypothesize that 3 first-order latent factors (personality/behavioral inhibition, risk taking, reward/punishment value) will account for the significant relations among the measures within each factor, and a single latent second-order factor (impulsive decision-making) will account for the relationships among the 3 first-order factors. We will test the abilit of our model to predict real world cocaine use and clinical outcome. Aim 1. Obtain self-report and task-based measures of 1) impulsivity~ 2) response inhibition~ 3) decision- making~ and 4) temporal discounting in cocaine abusers and matched controls in order to examine the correlational structure among the measures and test our model of Impulsive Choice. Aim 2a. Compare the structural model and the scores for each factor between groups. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both groups, but cocaine abusers will have greater scores on all factors. Aim 2b. Evaluate the predictive validity of our factors with respect to cocaine use. We hypothesize a positive relationship between our factors and current cocaine use. Aim 3. Compare the structural model and the scores for each factor between sexes. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both sexes with the following rank order of factor scores: Female Cocaine Abusers > Male Cocaine Abusers > Male Controls > Female Controls. Aim 4a. Evaluate the predictive validity of our factors in 35 cocaine users with respect to neural measures of response inhibition and temporal discounting. Aim 4b. Evaluate whether the factors predict neural activity associated with decisions to smoke cocaine measured using a novel fMRI task (CNET) in 35 cocaine users. We hypothesize that our factors, with incorporation of neural measures of response inhibition and temporal discounting, will predict neural activity related to decisions to smoke cocaine and self-reported cocaine use. Aim 5. Evaluate the predictive validity of our factors with respect to treatment outcome for 100 participants for whom we will provide cognitive-behavioral treatment (CBT) for their cocaine use. We hypothesize that there will be a negative relationship between our factors and clinical outcome. Impact: A better understanding of the construct of impulsivity and which factors of impulsivity best predict clinica outcome will provide critical information to guide the development of therapies specifically targeting cognitive processes associated with those factors in drug taking.

描述（由申请人提供）：可卡因用户1）基于自我报告措施，更冲动性，2）在抑制行为反应方面的难度更大，3）在决策任务中做出更差的决策，4）4）与非​​可卡因用户相比，以更快的速度来折扣未来奖励的价值，这表明冲动在可口可乐滥用中发挥了巨大的作用。在当前可卡因施虐者（n = 200）和匹配的对照组中收集了这4个域的数据（n = 180）之后，我们将进行验证性因素分析，以测试冲动选择的二阶因子模型。我们假设3个一阶潜在因素（人格/行为抑制，冒险，奖励/惩罚价值）将解释每个因素内的措施之间的显着关系，并且一个潜在的二阶因素（冲动性决策）将解释3个一阶因素之间的关系。我们将测试模型的余地，以预测现实世界可卡因的使用和临床结果。目的1。获得自我报告和基于任务的度量1）冲动性〜2）响应抑制〜3）决策 - 做出〜和4）在可卡因施虐者中进行时间折扣，并匹配的控制措施，以检查措施之间的相关结构并测试我们的脉动选择模型。目标2a。比较组之间每个因素的结构模型和得分。我们假设在两组中都会观察到我们的冲动选择模型的4个潜在因素，但是可卡因滥用者在所有因素上的得分都会更高。目标2B。评估我们因使用可卡因的预测有效性。我们假设因素与当前可卡因使用之间存在正相关关系。目标3。比较性别之间每个因素的结构模型和分数。我们假设，在两性中，我们的冲动性选择模型的4个潜在因素都将在以下等级分数的等级顺序中观察到：女性可卡因施虐者>雄性可卡因滥用者>男性控制>男性控制>女性对照。目标4a。评估35位可卡因使用者在反应抑制和时间折扣的神经测量方面的预测有效性。目标4B。评估这些因素是否预测了使用35位可卡因使用者中使用新颖的功能磁共振成像任务（CNET）测量的烟雾可卡因的决定相关的神经活动。我们假设，通过纳入抑制反应抑制和时间折扣的神经测量的因素将预测与烟气可卡因和自我报告可卡因使用的决策有关的神经活动。 AIM 5。评估100名参与者的因素在治疗结果方面的预测有效性，我们将为他们提供可卡因使用的认知行为治疗（CBT）。我们假设我们的因素与临床结果之间将存在负相关关系。影响：更好地理解冲动性的结构，以及哪些冲动性最佳预测临床结果将提供关键信息，以指导疗法的发展，专门针对吸毒中与这些因素相关的认知过程。